| NPI | 1518280965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60420848) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA LH60354442) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2025-02-12 |